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A prominent Italian surgeon could face dismissal from Sweden's Karolinska Institute after Sweden's state broadcaster SVT claimed that he had carried out an experimental operation on a woman in Russia without the Institute's approval.

The woman later became seriously ill and died.

Paolo Macchiarini, famed for his pioneering use of stem cells in regenerative surgery, was reported to the Swedish medical authorities by four doctors in 2014, accused of research misconduct and carrying out procedures without ethical permission, but was cleared by an internal investigation.

However, Anders Hamsten, President of the Karolinska Institute, said that the revelations in the SVT documentary The Experiments (Experimenten), if true, meant he could no longer remain at the institute.

"We must see the business as an ‘action which undermines our trust'. This is something which our colleagues should not engage in. It's very clear in our rules," he said.

"One must have confidence in one's colleagues and if that trust is damaged, you cannot continue," he said.

Hamsten said that his confidence in Professor Macchiarini had also been damaged by claims in an article in Vanity Fair earlier this month that he had fabricated elements of his CV.

Until his interview with SVT on Thursday, Hamsten had defended Macchiarini for years in the face of repeated warnings, so his sudden shift in tone could mean the beginning of the end for the Italian “super-surgeon”.

Macchiarini won fame in 2011 for carrying out the first synthetic organ transplant, making a trachea – or windpipe – from plastic, and using it as a frame into which the patient's own stem cells could then grow.

He later carried out the procedure on Hannah Warren, a two-year-old Korean girl.

However, Andemariam Teklesenbet Beyene, the man who received the first transplant, later developed an increasingly bad and then bloody cough, and then died, incubated, in the Karolinska hospital.

Warren, meanwhile, died just two months after the operation took place, as her lungs deteriorated.

In the documentary Experimenten, Macchiarini admits that his synthetic trachea did not appear to work in its current state, but said that he did not feel it had been wrong to continue testing it on further patients.

After the Karolinska Institute cleared Macchiarini, he described the whole experience as “every researcher's nightmare”.

They had been, he said “extremely damaging: to me, to my team and to the whole field of regenerative medicine”.